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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

Texas rates for HCPCS A5514

For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

Rates data updated July 2026.

Facilitymedian $55 · 10th–90th $35$1580%10%10th90th$55Professionalmedian $33 · 10th–90th $26$460%10%20%10th90th$33$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$34.67
Typical High
$38.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$35.48
Typical High
$46.77
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$51.29
Typical High
$85.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$66.07
Typical High
$147.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$46.77
Typical High
$67.61
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$741.31
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$35.48
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$407.38
Typical High
$407.38
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$54.95
Typical High
$81.28
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$46.77
Typical High
$54.95
Molina
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Providence
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$54.95
Typical High
$81.28
Providence
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$35.48
United
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$43.65
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$31.62
Typical High
$38.90
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$74.13